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--- en:misc:talk-qa-saine-schwarcz [2013/02/07 12:03]
legatum [QUESTION 2]
+++ en:misc:talk-qa-saine-schwarcz [2013/02/08 14:51]
legatum [QUESTION 6]
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 ===== QUESTION 5 =====
-It is astonishing to note that a "man of science" would consider the Shang et al. 2005 meta-analysis published in the Lancet the "definitive meta-analysis[(Schwarcz J. Answer to a homeopath’s criticism. //Chemically Speaking// June 5, 2012.)]" —notwithstanding the fact that major flaws have been underlined by a large number of scientists[(Bornhöft G, Matthiessen P. Homeopathy in Healthcare. //Effectiveness, Appropriateness, Safety and Costs//. Herdecke: Springer, 2011, 39-46. )] [(Frass M, Schuster E, Muchitsch I, Duncan J, Gei W, Kozel G, Kastinger-Mayr C, Felleitner AE, Reiter C, Endler C, Oberbaum M. Bias in the trial and reporting of trials of homeopathy: a fundamental breakdown in peer review and standards? //Journal of Alternative and Complementary Medicine// 2005; 11: 780.)] [(Iris R. Bell. All evidence is equal, but some evidence is more equal than others: can logic prevail over emotion in the homeopathy debate? //Journal of Alternative and Complementary Medicine// 2005; 11: 763-769.)] [(Walach H, Jonas W, Lewith G. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005; 366: 2081.)] [(Haselen RV. The end of homeopathy: wishful thinking? //Complementary Therapies in Medicine// 2005; 13: 229-230.)] [( Reilly D. Sir: is that bias? //Journal of Alternative and Complementary Medicine// 2005; 11: 785.)] [(Milgrom LR. Homeopathy and the new fundamentalism: a critique of the critics. //Journal of Alternative and Complementary Medicine// 2008; 14: 589-594.)] [(Jobst KA. Homeopathy, Hahnemann, and The Lancet 250 years on: a case of the emperor's new clothes? //Journal of Alternative and Complementary Medicine// 2005; 11: 751-754. )] [(Kiene H, Kienle GS, Schön-Angerer TV. Failure to exclude false negative bias: a fundamental flaw in the trial of Shang et al. //Journal of Alternative and Complementary Medicine// 2005; 11: 783.)] [(Peters D. Shang et al. Carelessness, collusion, or conspiracy? //Journal of Alternative and Complementary Medicine// 2005; 11: 779-780. )] [(Rutten ALB, and Stolper CF. The 2005 meta-analysis of homeopathy: the importance of post-publication data. //Homeopathy// 2008; 97: 169–177. )] [(Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. //Journal of Clinical Epidemiology// 2008; 61: 1197- 204. )] [(Flávio Dantas. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2083. )] [(Frass M, Singer SR, Oberbaum M. Homeopathic research after the Lancet meta analysis—A moment for introspection. //Complementary Therapies in Medicine// 2005; 13: 303-305 )] [(Fisher P, Berman B, Davidson J, Reilly D, Thompson T, Bell IR, Belon P, Bolognani F, Brands M, Connolly T, Dantas F, Endle PC, De Freitas F, Dean ME, Eizayaga F, Eizayaga J, Jansen JP, Jobst K, Koster D, Lewith G, Mathie R, Mercer S, Nicolai T, Oberbaum M, Peters D, Poitevin B, Rutten L, Schwartz G, Spence D, Steinsbekk A, Thompson E, Walach H, Whitehouse PJ. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2082-2083. )]) —if only for the fact that six of the eight large studies used in the final analysis were not following the rule of individualization, which is fundamental to homeopathy. Do you still think that this meta-study, which is composed of a majority of studies that violate this fundamental principle, can be used as proof against homeopathy? How do you explain that the accompanying editorial of the Lancet[(Editorial. The end of homeopathy. //Lancet// 2005; 366: 690.)] was able to come up to such radical conclusions, despite the fact that the study didn’t even adhere to the QUORUM guidelines for meta-analyses[(Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. //Lancet// 1999; 354: 1896-1900.)], and that the body of scientific evidence on homeopathy extends much beyond the limitations of the Shang et al. meta-analysis?
+**It is astonishing to note that a "man of science" would consider the Shang et al. 2005 meta-analysis published in the Lancet the "definitive meta-analysis[(Schwarcz J. Answer to a homeopath’s criticism. //Chemically Speaking// June 5, 2012.)]" —notwithstanding the fact that major flaws have been underlined by a large number of scientists[(Bornhöft G, Matthiessen P. Homeopathy in Healthcare. //Effectiveness, Appropriateness, Safety and Costs//. Herdecke: Springer, 2011, 39-46. )] [(Frass M, Schuster E, Muchitsch I, Duncan J, Gei W, Kozel G, Kastinger-Mayr C, Felleitner AE, Reiter C, Endler C, Oberbaum M. Bias in the trial and reporting of trials of homeopathy: a fundamental breakdown in peer review and standards? //Journal of Alternative and Complementary Medicine// 2005; 11: 780.)] [(Iris R. Bell. All evidence is equal, but some evidence is more equal than others: can logic prevail over emotion in the homeopathy debate? //Journal of Alternative and Complementary Medicine// 2005; 11: 763-769.)] [(Walach H, Jonas W, Lewith G. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005; 366: 2081.)] [(Haselen RV. The end of homeopathy: wishful thinking? //Complementary Therapies in Medicine// 2005; 13: 229-230.)] [( Reilly D. Sir: is that bias? //Journal of Alternative and Complementary Medicine// 2005; 11: 785.)] [(Milgrom LR. Homeopathy and the new fundamentalism: a critique of the critics. //Journal of Alternative and Complementary Medicine// 2008; 14: 589-594.)] [(Jobst KA. Homeopathy, Hahnemann, and The Lancet 250 years on: a case of the emperor's new clothes? //Journal of Alternative and Complementary Medicine// 2005; 11: 751-754. )] [(Kiene H, Kienle GS, Schön-Angerer TV. Failure to exclude false negative bias: a fundamental flaw in the trial of Shang et al. //Journal of Alternative and Complementary Medicine// 2005; 11: 783.)] [(Peters D. Shang et al. Carelessness, collusion, or conspiracy? //Journal of Alternative and Complementary Medicine// 2005; 11: 779-780. )] [(Rutten ALB, and Stolper CF. The 2005 meta-analysis of homeopathy: the importance of post-publication data. //Homeopathy// 2008; 97: 169–177. )] [(Lüdtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. //Journal of Clinical Epidemiology// 2008; 61: 1197- 204. )] [(Flávio Dantas. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2083. )] [(Frass M, Singer SR, Oberbaum M. Homeopathic research after the Lancet meta analysis—A moment for introspection. //Complementary Therapies in Medicine// 2005; 13: 303-305 )] [(Fisher P, Berman B, Davidson J, Reilly D, Thompson T, Bell IR, Belon P, Bolognani F, Brands M, Connolly T, Dantas F, Endle PC, De Freitas F, Dean ME, Eizayaga F, Eizayaga J, Jansen JP, Jobst K, Koster D, Lewith G, Mathie R, Mercer S, Nicolai T, Oberbaum M, Peters D, Poitevin B, Rutten L, Schwartz G, Spence D, Steinsbekk A, Thompson E, Walach H, Whitehouse PJ. Are the clinical effects of homoeopathy placebo effects? //Lancet// 2005: 366: 2082-2083. )]) —if only for the fact that six of the eight large studies used in the final analysis were not following the rule of individualization, which is fundamental to homeopathy. Do you still think that this meta-study, which is composed of a majority of studies that violate this fundamental principle, can be used as proof against homeopathy? How do you explain that the accompanying editorial of the Lancet[(Editorial. The end of homeopathy. //Lancet// 2005; 366: 690.)] was able to come up to such radical conclusions, despite the fact that the study didn’t even adhere to the QUORUM guidelines for meta-analyses[(Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. //Lancet// 1999; 354: 1896-1900.)], and that the body of scientific evidence on homeopathy extends much beyond the limitations of the Shang et al. meta-analysis?**
+===== QUESTION 6 =====
+**In the debate, you said of Professor Rustum Roy of Penn State University, "Rustum Roy, who was referred to, is not highly regarded in the scientific community. He is one of those outliers. And there are many such." On what basis do you base your opinion that Professor Roy is not highly regarded in the scientific community? Are you aware that in 2003 the ISI (Phila) rated his lab the #1 in the world on the basis of highly cited scholars[(Roy R. Interdisciplinary materials research: the reluctant reformer of Western science. //Facets// 2005; 4: 18-21. )] and that he has published over 1,000 papers in peer-review journals? Which ones of his results are therefore not trustworthy? How do you decide whether a scientific article published in a peer-reviewed journal is trustworthy, such as the one of Roy in Materials Science[(Roy R, Tiller WA, Bell I, Hoover MR. The structure of liquid water; novel insights from materials research; potential relevance to homeopathy. //Materials Research Innovations// 2005; 9: 577-608.)] in 2005 or the one of Chikramane in Langmuir[(Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. //Langmuir// 2012; 28: 15864-15875.)] in 2012?**
+===== QUESTION 7 =====
+**You wrote, "Dr. Edzard Ernst, one of the world’s foremost experts on homeopathy ..."[(Schwarcz J. Answer to a homeopath’s criticism. //Chemically Speaking// June 5, 2012.)] Yet, Edzard Ernst, a known skeptic of alternative medicine, who has authored at least five systematic reviews and meta-analyses on homeopathy, and who has been portraying himself professionally as a trained homeopath[(Ernst E: A systematic review of systematic reviews of homeopathy. //British Journal of Clinical Pharmacology// 2002; 54: 581. )] —which would be illegal in Germany for a practicing physician to falsely use this title—even to the point of stressing this point in November 2009 before the British House of Commons, "Many years ago, I have worked as a homeopath and therefore understand the concepts of homeopathy[(Ernst E. Memorandum submitted by Edzard Ernst HO 16.
+http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm1602.htm )]," has denied in an interview published in April 2010 ever having completed any course in homeopathy[(Kösters C. Interview mit Professor Edzard Ernst, Exeter. //Homöopathische Nachrichten des DZVhÄ// 2010 (April): 1-3. )]. Further, Richard Horton, the editor in chief of the Lancet, said, "Professor Ernst seems to have broken every professional code of scientific behaviour[(Horton R. Letters. //The Times//. Monday August 29, 2005.)]." How is it that, as a professional quackbuster[(Latimer J. Who you gonna call ? Quackbuster Joe Schwarcz exposes pseudoscience of all sorts. His next target ? Homeopathic Medicine. //Macleans Magazine//. March 26, 2012: 51)], you are unaware of this delusion and you were still claiming in June 2012 that Ernst has credibility in the scientific world as an expert on homeopathy?**
+To suggest that Edzard Ernst has no credibility is pure folly. His writings are all thoroughly documented. He never claimed to be a homeopath ( why would anyone who isn't one do that? Hardly a badge of honour). He just claimed to have worked in a homeopathic hospital where he was exposed to all the tenets of homeopathy. In any case what does whether he was a homeopath or not have to do with anything? Let the facts speak.
+===== QUESTION 8 =====
+**I am curious to know which research papers I presented in this debate on homeopathy represent "a plundering of science," and can you please explain on what basis they don’t abide by the strictest scientific method?**
+===== QUESTION 9 =====
+**You said in the debate, "And Hahnemann was aware of this and he experimented on himself. He wanted to know: What was the right dose to give to his patients? So, he kept taking bigger and bigger doses to see what would happen. And he took these doses and, eventually, he developed a fever, much like he saw in his malaria patients and then came to the conclusion that a substance that—in a healthy person—causes a certain disease can cure a sick person who has those symptoms. … Remember that Hahnemann started with the whole notion of taking cinchona in larger and larger doses to trigger the symptoms of malaria. That’s the foot upon which homeopathy stands originally. Has anyone ever tried to replicate that? Yes. In 1991, German Professor Wolfgang Hopff did the experiment, started to take cinchona bark in bigger and bigger doses and never got a fever; he never got the malaria symptoms. So we don’t know what happened in the case of Hahnemann. Maybe he was unlucky. He was taking the cinchona doses and he got the flu at the same time. And that’s what caused the fever." It is interesting to note, first, that Hahnemann never reported wanting "to know: What was the right dose to give to his patients?," but instead clearly stated that he wanted to know the principle underlying the effectiveness of cinchona bark in malaria; second, that he never reported having taken increasing doses, but instead took the same dose twice a day; third, that he never reported having had developed a fever or the "peculiar chilly shivering rigor" of malaria during his proving of cinchona bark tincture[(Hahnemann S. Annerhung Hahnemann zu seinem Seibstversuch mit Chinarinde. In: Cullen W. //Abhandlung über die Materia medica. Aus dem Englischen mit mit Anmerkungen von Samuel Hahnemann//. Band II. Leipzig: Schwickertschen Verlag,1790, 108-109. A translation of this passage can be found in: Bradford TL. //The Life and Letters of Dr. Samuel Hahnemann//. Philadelphia: Boericke & Tafel, 1895, 36-37.)] ; and fourth, that fever is a very common symptom of acute cinchonism[(Goldberg AM, Wexler LF. Quinine overdose: review of toxicity and treatment. //Clinical Cardiology// 1988; 11: 716-718)] , quinine "also has a mild antipyretic effect[(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)]," and that every single one of the eight most recent cases of acute cinchonism that I could find in the scientific literature had developed a fever.[(Katz B, Weetch M, Chopra S. Quinine-induced granulomatous hepatitis. //British Medical Journal// 1983; 86: 264-265. )] [(Bateman DN, Dyson EH. Quinine toxicity. //Adverse Drug Reactions and Acute Poisoning Reviews// 1986; 5: 215-233.)] [(Mathur S, Dooley J, Scheuer PJ. Quinine induced granulomatous hepatitis and vasculitis. //British Medical Journal// 1990; 300: 613.)] [(Punukollu RC, Kumar S, Mullen KD. Quinine hepatotoxicity: an underrecognized or rare phenomenon? //Archives of Internal Medicine// 1990; 150: 1112-1113. )] [(Wolf LR, Otten EJ, Spadafora MP. Cinchonism: two case reports and review of acute quinine toxicity and treatment. //Journal of Emergency Medicine// 1992; 10: 295-301. )] [(Perez JA, Stryker J, Arsura EL, Hewitt JM. Probable quinine-induced hepatotoxicity. //Western Journal of Medicine// 1994; 160: 59-60.)] [(Farver D, Lavin MN. Quinine-induced hepatotoxicity. //Annals of Pharmacology// 1999; 33: 32-34. )] Can you please provide primary source references documenting your version of Hahnemann’s proving of cinchona bark and why are you referring to a Professor Hopff’s experimentation[(Perhaps it is not Hopff in 1991 but Habermann in 1997 that carried a two-hour (?) proving with 3.3 grams of cinchona bark without noticing any rise in temperature, see: Krämer HJ, Habermann E. Ein Vorlesungsversuch zur Homöopathie. //Deutsches Ärzteblatt// 1997; 94: A1851-1852.)] when the scientific literature is extremely clear on this point, namely, that fever is a very common occurrence of acute cinchonism?**
+{{anchor:schwarcz_answers}}
+===== DR. JOE SCHWARCZ’S ANSWERS =====
+As far as this second set of questions goes, I'm just not willing to devote any more time to this discussion. I think I have already spent far more time discussing homeopathy than the subject deserves. I'm not going to get into it any more for the same reason I don't get into discussion with Creationists or various conspiracy theorists. Furthermore I have essentially answered these questions either in the attached or in previous writings. I will make just a couple of comments though.
+I certainly do warn about the dangers of conventional medicine when appropriate and have written extensively on the issue. (incidentally the term "allopathic" was devised as a derogatory term by Hahnemann ) But that is not the question here. The question is whether homeopathy is bogus or not.
+Andre is totally unaware that the issues he brings up have been the subject of numerous scientific discussions and that books have been written on them. The claims about cholera and flu and homeopathy have been addressed and the explanation is obvious. "Heroic" treatments were actually harmful while homeopathic ones were just useless. It is true that homeopathic hospitals had better hygiene, but that had nothing to do with the concept of homeopathy.
+To suggest that Edzard Ernst has no credibility is pure folly. His writings are all thoroughly documented. He never claimed to be a homeopath ( why would anyone who isn't one do that? Hardly a badge of honour). He just claimed to have worked in a homeopathic hospital where he was exposed to all the tenets of homeopathy. In any case what does whether he was a homeopath or not have to do with anything? Let the facts speak.
+If Andre claims to have cured a patient of cystic fibrosis with homeopathy he should submit the data to a reputable journal as a case report. If he can reproduce the cure he should be nominated for a Nobel Prize, or at least a Lasker Award.
+As far as consulting fees, the sum total is $0. My salary comes from McGill.
+Andre, as one might expect, is not familiar with chemical history. Avogadro's number was named after him, not by him. Hahnemann could not have had any idea about the number of atoms or molecules in a mole.
+The motive behind the lawsuit is simple. Homeopathic medications are claimed to have active ingredients without any proof that they contain such. Therefore they are mislabeled. The lawsuit is being funded totally by a group of lawyers who initiated it. I had nothing to do with it but of course I do support it because I think all products that make medical claims should be held to the same standards of safety and efficacy. Homeopathic products are getting a free ride.
+Questions like #24 are so puerile and smack so strongly of the ignorance of scientific methodology that they don't merit further discussion.
+As to the final question, we take full responsibility for whatever information we disseminate. The scientific community stands firmly behind the notion that homeopathy is nothing other than an example of the placebo effect. Data can be dredged up to attempt to counter the evidence the same way that Creationists publish all sorts of papers that sound scientific and appear to be so to the uninitiated. But of course Creationism is bogus. How many serious scientists think the Earth is 5700 years old? How many think that homeopathy is more than placebo?
+Anyway, as I said, this discussion has gone far enough and I do not want to devote more time to it. If Andre would like to publicize his ideas further, there is a way to do it. The lawyers are actually looking for a homeopath to include in the lawsuit, and if Andre desires I could put him in touch with them. He could state his case then in a very public forum and get lots of attention.
+===== References =====
+~~REFNOTES~~
+====== DOCUMENT DESCRIPTOR ======
+^ Source: | http://www.homeopathy.ca/debates_2012-11-27_FromDrSaine-to-DrSchawrtz.shtml |
+^ Description: | Questions posted by Dr. André Saine to Dr. Joe Schwarcz as a follow-up on the [[en:misc:talk-saine-schwarcz|Debate held at McGill University]] on November 27, 2012.  |
+^ Year: | 2013 |
+^ Editing: | errors only; interlinks; formatting |
+^ Attribution: | http://www.homeopathy.ca |

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